HHS Secretary: Expect tweaks to nursing home rating system

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Department of Health and Human Services Secretary Kathleen Sebelius
Department of Health and Human Services Secretary Kathleen Sebelius

The nation's first nursing home rating system is an important tool for consumers, but changes can be expected, said the country's highest health official on Tuesday. Health and Human Services Secretary Kathleen Sebelius said criticism about always assigning certain percentages of facilities “excellent” or “failing” grades is “serious” and deserves further consideration.

“The suggestion that it's a flawed snapshot because it forces the reviewers at the outset to make decisions that may or may not be accurate … I think that's serious criticism that needs to be looked at,” Sebelius said shortly before delivering a keynote address at the annual conference of the National Council on Aging and The American Society on Aging in Chicago. “The last thing we want to do is have an arbitrary bell curve just for the sake of having a system.

“We need to have some standards; they need to be clear, need to be accurately measured and if everyone ends up being excellent or everyone ends up being failing, so be it,” she added. “But somehow this sort of bell curve seems to have some inherent flaws.”

Long-term care providers have complained about regulators' predetermined percentages for how many five-star and one-star facilities are identified with each update. Providers also believe the Five-Star Quality Rating System's foundation has relied too much on a subjective, faulty inspection system ever since the system was hurried into place during the last few weeks of 2008 under the previous administration.

Sebelius was clear that she expects tweaks to be made to the system. “Absolutely. I think we need to make sure it isn't flawed inherently. But should we have a rating system? You bet.”